Róisín Shortall (Dublin North West, Labour)

I thank Deputy O'Donovan for raising this issue. Oral health services span primary, secondary and tertiary care services, including acute hospitals. The Department of Health agrees objectives and performance indicators with the Health Service Executive for the public dental service and dental treatment services scheme, DTSS, and oversees the development of policy and service delivery in this regard. The DTSS is provided by contracted dental practitioners and the public dental service is provided by salaried dental staff of the HSE.

The current goal for the DTSS is the provision of a basic level of service within budget to medical card holders. Unfortunately, owing to the current position of the public finances, it has been deemed necessary to reduce the services available under the scheme. However the Health Service Executive has measures in place to ensure patients with special needs, high risk patients and those who have greater clinical needs receive priority for treatment. In addition, a free oral examination every calendar year and free emergency dental treatment with a focus on the relief of pain and sepsis are available to all eligible patients.

The current goals for the public dental service are the provision of pain and emergency services for children aged under 16 years and routine care for targeted classes of primary school children with the provision of advanced, specialist and consultant care in hospital settings. Orthodontic services, which are also delivered by salaried dental staff of the HSE, are provided to eligible patients based on the level of clinical need. Oral and maxillofacial surgery are delivered either by secondary or tertiary services. The HSE intends to review the delivery of orthodontic services and all possible avenues related to internationally recognised models of good practice will be considered in that context.

The HSE is implementing the recommendations of the strategic review of the management and delivery of dental services undertaken in 2010. This includes the development of a national oral health office and an inspectorate. A national oral health lead has been appointed on an interim basis and is leading the implementation of the recommendations, which place a particular emphasis on probity and governance issues.

The National Recovery Plan 2012-2014 provides for changes in the existing range of dental services and supports provided through the health care and social protection systems to improve access to essential dental services for those most in need. This proposal is being considered in the context of the comprehensive review of expenditure. The current moratorium on the filling of posts has meant the Department of Health has not been in a position to fill the post of chief dental officer. Future decisions on this post will be taken against the backdrop of the Department's need to balance the delivery of business priorities with falling levels of overall resources.

See this speech in context